This is a Study to Learn About How the Combination of the Study Medicines Sigvotatug Vedotin Plus Pembrolizumab Works in People With Non-small Cell Lung Cancer With High Levels of PD-L1.
Sigvotatug Vedotin: MMAE-Antibody Drug Conjugate targeting Integrin Beta-6
Pembrolizumab: Anti-PD-(L)1
Study summary
The purpose of the study is to compare how the new combination treatment (Sigvotatug Vedotin plus pembrolizumab) works compared to pembrolizumab alone in patients with non-small cell lung cancer (NSCLC) with high levels of PD-L1. This is a protein that acts as a kind of "brake" to keep the body's immune responses under control.
The study is seeking for participants who:
* Are confirmed to have NSCLC (Stage 3 or 4).
* Have PD-L1 levels in more than 50% of the cancer cells.
All participants in this study will receive pembrolizumab at the study clinic once every 6 weeks as an intravenous (IV) infusion (give directly into a vein). In addition, half of the participants will also receive Sigvotatug Vedotin once every 2 weeks as an IV infusion in addition to receiving pembrolizumab.
Participants may receive pembrolizumab for up to about two years. Those participants taking Sigvotatug Vedotin can continue until their NSCLC is no longer responding. The study team will monitorsee how each participant is doing with the study treatment during regular visits at the clinic.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
1. Participants must meet the following criteria:
1. Have pathologically confirmed Stage IIIB or IIIC NSCLC and not be a candidate for surgical resection or definitive chemoradiation, or Stage IV NSCLC per the AJCC Staging Manual (Version 8.0) and the UICC Staging System (Eighth edition).
2. Participants with non-squamous histology must have documented negative test results for EGFR, ALK, and ROS1 AGAs and no known AGAs in NTRK, BRAF, RET, MET, or other AGAs with approved front-line therapies per local standard of care.
3. Large cell neuroendocrine carcinoma is excluded.
4. Candidate for treatment with pembrolizumab monotherapy per local guidelines.
2. Tumor has PD-L1 expression in ≥50% of tumor cells (TPS ≥50%) as determined by local testing
3. Measurable disease based on RECIST v1.1 per investigator.
4. Resolution of acute effects of any prior therapy to either baseline severity or NCI CTCAE Grade 1 or less (except for AEs not constituting a safety risk in the investigator's judgment), unless otherwise excluded.
Exclusion Criteria:
1. Life expectancy of \<3 months in the opinion of the investigator.
2. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or make the participant inappropriate for the study.
3. Participants with any history of another malignancy within 3 years before the first dose of study intervention, or any evidence of residual disease from a previously diagnosed malignancy.
4. Known or suspected hypersensitivity, intolerance, or contraindication to any excipient contained in the drug formulation of sigvotatug vedotin or pembrolizumab.
5. Participants with any of the following respiratory conditions:
1. Evidence of noninfectious or drug-induced ILD or pneumonitis
2. Known DLCO (adjusted for hemoglobin) \<50% predicted.
3. Grade ≥3 pulmonary disease unrelated to underlying malignancy
6. Known active CNS lesions are excluded. Participants with definitively treated brain metastases (surgery and/or radiotherapy) may be eligible. Clinically inactive brain metastases of longest diameter \<0.5 cm are permitted.
7. Major surgery (defined as a surgery requiring inpatient hospitalization of at least 48 hours) within 21 days or minor surgery within 7 days prior to first dose of study intervention.
8. Receipt of a live vaccine within 30 days prior to first dose of study intervention.
9. Pre-existing peripheral neuropathy Grade ≥2 per NCI CTCAE v5.0.
10. Uncontrolled diabetes mellitus, defined as HbA1c ≥8.0% or HbA1c between 7.0% and 8.0% with associated diabetes symptoms (polyuria or polydipsia) that are not otherwise explained.
11. Prior immune-related AE that led to anti-PD-(L)1 treatment discontinuation, required a high-dose steroid taper (≥0.5 mg/kg prednisone or equivalent per day) for \>2 weeks, or required treatment with systemic immunosuppressive therapy.
12. History of autoimmune disease that has required systemic treatment in the past 2 years
13. Participants with prior solid organ or bone marrow transplantation.
14. Currently receiving a high-dose steroid (\>10 mg prednisone or equivalent per day) or other immune suppressant or has a condition requiring a chronic high-dose steroid or immune suppressant.
15. Prior and concomitant therapy:
1. Any prior treatment with MMAE-derived drugs or IB6 targeting agents.
2. Prior systemic therapy, including anti-PD-(L)1 therapy, for locally advanced, unresectable, or metastatic NSCLC.
* (Neo)adjuvant anti-PD-(L)1 is allowed if recurrence or progression occurred ≥9 months after the last dose.
* Other (neo)adjuvant or definitive therapy is allowed if recurrence or progression occurred ≥6 months after the last dose.
3. Prior radiotherapy to the lung within 6 months of first dose of study intervention, referencing the last date radiotherapy was received.
4. Chemotherapy, biologics, and/or other antitumor treatment with immunotherapy not specifically prohibited that is completed less than 4 weeks prior to first dose of study intervention, or 2 weeks for palliative radiotherapy.
5. Any prior therapy with an immune-oncology agent directed to a stimulatory or co-inhibitory T-cell receptor
16. History of or current ongoing infection, including participants positive for active HIV, HBV, or HCV.
17. Severe uncontrolled cardiac or cerebrovascular condition within the previous 6 months
Primary outcome measure(s)
Overall Survival — Baseline to date of death from any cause (Approximately 2 years) Overall survival defined as the duration from enrollment to death.
Progression Free Survival (PFS) assessed by blinded independent central review (BICR) — From Baseline to to date of first documentation of progression OR death (Approximately 2 year) Progression-free survival is defined as the time interval from the date of randomization to the date of first documented tumor progression determined by blinded independent central review (BICR) assessment as per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) or death due to any cause, whichever come first.
Trial sites (372)
Facility
City
Region
Status
Providence Medical Foundation
Fullerton
California
Recruiting
Providence St. Jude Medical Center Virginia K. Crosson Cancer Center and Infusion Center
Fullerton
California
Recruiting
St. Jude Heritage Medical Group - Fullerton Plaza Multi-Specialty Clinic (Pulmonary Function Test)
Fullerton
California
Recruiting
Intermountain Health Cancer Center Lutheran Hospital
Golden
Colorado
Recruiting
Cancer Centers of Colorado St. Mary's Regional Hospital
Grand Junction
Colorado
Recruiting
Intermountain Health St. Mary's Regional Hospital
Grand Junction
Colorado
Recruiting
Intermountain Health
Grand Junction
Colorado
Recruiting
Intermountain Health Lutheran Hospital
Wheat Ridge
Colorado
Recruiting
Washington DC Veterans Affairs Medical Center
Washington D.C.
District of Columbia
Recruiting
Mid Florida Hematology and Oncology Center
Orange City
Florida
Recruiting
BRCR Global
Plantation
Florida
Recruiting
Endeavor Health
Elmhurst
Illinois
Recruiting
Hope and Healing Cancer Services
Hinsdale
Illinois
Recruiting
Endeavor Health
Naperville
Illinois
Recruiting
Hope and Healing Cancer Services
New Lenox
Illinois
Recruiting
Saint Luke's South Hospital
Overland Park
Kansas
Recruiting
Maine Medical Center
Portland
Maine
Recruiting
MaineHealth Cancer Care - Scarborough
Scarborough
Maine
Recruiting
MaineHealth Cancer Care and Blood Disorders Scarborough
Scarborough
Maine
Recruiting
Southcoast Centers for Cancer Care
Fairhaven
Massachusetts
Recruiting
Southcoast Centers for Cancer Care
Fall River
Massachusetts
Recruiting
Corewell Health - Butterworth Hospital
Grand Rapids
Michigan
Not Yet Recruiting
Corewell Health - Lemmen Holton Cancer Pavilion
Grand Rapids
Michigan
Not Yet Recruiting
Corewell Health - Research Specimen Processing Area
Grand Rapids
Michigan
Not Yet Recruiting
Corewell Health Investigational Drug Services
Grand Rapids
Michigan
Not Yet Recruiting
Corewell Health
Grand Rapids
Michigan
Not Yet Recruiting
Minnesota Oncology Hematology, PA
Burnsville
Minnesota
Recruiting
Minnesota Oncology Hematology PA
Coon Rapids
Minnesota
Recruiting
M Health Fairview Cancer Clinic-Edina
Edina
Minnesota
Recruiting
Minnesota Oncology Hematology PA
Edina
Minnesota
Recruiting
Minnesota Oncology Hematology PA
Maple Grove
Minnesota
Recruiting
M Health Fairview St. John's Hospital
Maplewood
Minnesota
Recruiting
Minnesota Oncology Hematology PA
Maplewood
Minnesota
Recruiting
Hennepin County Medical Center
Minneapolis
Minnesota
Recruiting
North Memorial Health Cancer Center
Robbinsdale
Minnesota
Recruiting
Metro Minnesota Community Oncology Research Consortium (MMCORC)
Saint Louis Park
Minnesota
Recruiting
Park Nicollet Frauenshuh Cancer Center
Saint Louis Park
Minnesota
Recruiting
Regions Hospital
Saint Paul
Minnesota
Recruiting
Minnesota Oncology Hematology, P.A. Cornerstone Medical Specialty Center
Woodbury
Minnesota
Recruiting
Jackson Oncology Associates, PLLC
Jackson
Mississippi
Recruiting
+ 332 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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